Current guidelines recommend treatment optimization in virologically suppressed patients through switching/ simplification strategies to minimize long-term toxicities and improve adherence. The assessment of inflammation/ coagulation profiles may support therapeutic decisions. We undertook a prospective, non-randomized study to evaluate the efficacy and safety of switching to ABC/3TC from ZDV/3TC or TDF/FTC backbones, in 40 HIV-1 infected patients with HIV-RNA levels <37 copies/mL (>24 months). Main endpoints were viral load levels, CD4+ T cells and toxicities after 48 weeks. Serum inflammation/coagulation markers (ESR, CRP, D-dimer and fibrinogen) and pro-inflammatory cytokines (IL-6, TNF-α, adiponectin, resistin) were evaluated. Baseline characteristics were similar in the two arms, with significantly lower values of e-GFR in patients on TDF/FTC. Markers of inflammation/ coagulation and cytokine profile were also similar, except for higher values of resistin in patients on TDF/ FTC. During follow up, CD4+ T cells increased and viral load remained undetectable in both groups. Patient from ZDV/3TC had significantly greater changes in total cholesterol and serum creatinine. Markers of inflammation/ coagulation remained unchanged. Adiponectin significantly increased in patients from ZDV/3TC. Switching to ABC/3TC was effective and safe. Inflammatory markers remained low in both groups. Some changes in metabolic, kidney and cytokine profiles were apparently specific for baseline cART treatment.

Backbone switch to abacavir/lamivudine fixed-dose combination: implications for antiretroviral therapy optimization / Fantauzzi, Alessandra; Floridia, Marco; Falasca, Francesca; Turriziani, Ombretta; Vullo, Vincenzo; Mezzaroma, Ivano; Spanedda, Pierpaolo. - In: NEW MICROBIOLOGICA. - ISSN 1121-7138. - STAMPA. - 38:4(2015), p. 531-40.

Backbone switch to abacavir/lamivudine fixed-dose combination: implications for antiretroviral therapy optimization

FANTAUZZI, Alessandra;FALASCA, FRANCESCA;TURRIZIANI, Ombretta;VULLO, Vincenzo;MEZZAROMA, Ivano;SPANEDDA, Pierpaolo
2015

Abstract

Current guidelines recommend treatment optimization in virologically suppressed patients through switching/ simplification strategies to minimize long-term toxicities and improve adherence. The assessment of inflammation/ coagulation profiles may support therapeutic decisions. We undertook a prospective, non-randomized study to evaluate the efficacy and safety of switching to ABC/3TC from ZDV/3TC or TDF/FTC backbones, in 40 HIV-1 infected patients with HIV-RNA levels <37 copies/mL (>24 months). Main endpoints were viral load levels, CD4+ T cells and toxicities after 48 weeks. Serum inflammation/coagulation markers (ESR, CRP, D-dimer and fibrinogen) and pro-inflammatory cytokines (IL-6, TNF-α, adiponectin, resistin) were evaluated. Baseline characteristics were similar in the two arms, with significantly lower values of e-GFR in patients on TDF/FTC. Markers of inflammation/ coagulation and cytokine profile were also similar, except for higher values of resistin in patients on TDF/ FTC. During follow up, CD4+ T cells increased and viral load remained undetectable in both groups. Patient from ZDV/3TC had significantly greater changes in total cholesterol and serum creatinine. Markers of inflammation/ coagulation remained unchanged. Adiponectin significantly increased in patients from ZDV/3TC. Switching to ABC/3TC was effective and safe. Inflammatory markers remained low in both groups. Some changes in metabolic, kidney and cytokine profiles were apparently specific for baseline cART treatment.
antiretroviral therapy; backbone regimen; inflammatory cytokines; switch strategies
01 Pubblicazione su rivista::01a Articolo in rivista
Backbone switch to abacavir/lamivudine fixed-dose combination: implications for antiretroviral therapy optimization / Fantauzzi, Alessandra; Floridia, Marco; Falasca, Francesca; Turriziani, Ombretta; Vullo, Vincenzo; Mezzaroma, Ivano; Spanedda, Pierpaolo. - In: NEW MICROBIOLOGICA. - ISSN 1121-7138. - STAMPA. - 38:4(2015), p. 531-40.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/889838
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